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DR. DALLAS M RUSSELL MD NPI 1609879253


NPI Profile

NPI: 1609879253
Provider Name: DR. DALLAS M RUSSELL, MD
Classification:Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
790 MONTCLAIR RD
STE 210
BIRMINGHAM, AL
ZIP 35213
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Phone: (205) 595-3600

DR. Dallas M Russell, MD is a specialist in Birmingham, AL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Dallas M Russell, MD NPI is 1609879253. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

790 MONTCLAIR RD
STE 210
BIRMINGHAM, AL
ZIP 35213-966
Phone: (205) 595-3600
Fax: (205) 595-3663

The NPI 1609879253 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/27/2005 and was last updated on 3/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurology12098ALABAMANo
2174400000XSpecialist12098ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DG6844MEDICARE PINALABAMA
282356MEDICARE PINALABAMA
3C74517MEDICARE UPINALABAMA
451082356MEDICARE PINALABAMA
55290002380MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/9/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.